Declaration of Candidacy - District 5Revised 04/11/2023
CITY OFFICE
DECLARATION OF CANDIDACY
CANDIDATE FILING PERIOD (I.C. 50-410)OFFICE INFORMATION
Opens: August 28, 2023 (8:00 am)
Closes: September 8, 2023 (5:00 pm)
Filing for the Office of:
City Name:
CANDIDATE WITHDRAWAL DEADLINES (I.C. 34-1405A)Term length, sub-district,
zone, seat or position:
(if applicable)September 22, 2023 (5:00 pm)
CERTIFICATION
I, the undersigned, being a resident of the State of Idaho and of the city listed above, do hereby declare myself a candidate for the office entered
above to be voted on at the Election to be held on the _______ day of ______________________, 2023 and I certify that the information on this Declaration is
true and accurate.
I further certify that I possess the legal qualifications to hold said office. I submit herewith the filing fee of ($40.00), or in lieu of the filing fee the
nominating petition containing the five (5) signatures of qualified electors as statutorily required.
Dated:Candidate Signature:
Subscribed and sworn to before me this ______ day of __________________, _______.
Signature: ________________________________________________
Notary Public in and for the State of Idaho, residing at
_________________________________________________________
My Commission Expires: ____________________________________
NOTARY
SEAL
HERE
EC-3A - Declaration of Candidacy for City Offices – Approved by the Idaho Secretary of State
CAMPAIGN FINANCE INFORMATION
I do hereby certify that I am a registered elector of the State of Idaho and appoint myself as treasurer for my campaign. If any campaign
finance contributions or expenditures reach or exceed $500, I will create a Campaign Finance account with the Secretary of State, and may
at that time, appoint another person as Treasurer or remain as my own Treasurer.
Idaho Code 34-701(2) now requires phone numbers to be provided. Idaho Code 34-704(4) states
that all information in declarations of candidacy shall be made publicly available upon request.
BALLOT NAME
Write your name exactly as you would like it to appear on the ballot
CANDIDATE INFORMATION
Candidate Name (As it appears on your voter registration record.)Candidate Phone
First MI Last Suffix
Residence Address (As it appears on your voter registration record.)
Street Address City State Zip Code County
HOMESTEAD EXEMPTION (I.C. 34-107[2], 34-701[3])
Have you, or your spouse, claimed a homestead exemption? Yes No
If Yes, Please List the Address
Street Address City State Zip Code County
CITY COUNCIL DISTRICT 5
MERIDIAN
4 YEAR TERM
7th November